Journal of evaluation in clinical practice最新文献

{"title":"Validity and Reliability of the Berg Balance Scale in Different Tele-Assessment Methods in Patients With Stroke","authors":"Birol Önal,&nbsp;Nezire Köse,&nbsp;Şeyma Nur Önal,&nbsp;Hatice Yağmur Zengin","doi":"10.1111/jep.70141","DOIUrl":"https://doi.org/10.1111/jep.70141","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objective</h3>\u0000 \u0000 <p>Balance evaluation is essential for determining treatment and its effectiveness in stroke patients. Considering the widespread use of telehealth services, it is important to evaluate the applicability of balance scales for teleassessment. The aim in this study was to investigate the reliability and validity of the Berg Balance Scale (BBS) applied using synchronous and asynchronous teleassessment methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Teleassessments were performed by two physiotherapists. Synchronous assessments were conducted online in real time using the application Zoom, while asynchronous assessments involved patients recording videos according to a reference evaluation video sent to them. All tests were repeated 10 days later to assess intrarater reliability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-six stroke patients (mean age 55.9 ± 9.5 years) participated in the study. Both synchronous and asynchronous teleassessments of the Berg Balance Scale (BBS) demonstrated excellent interrater reliability, with ICC values of 0.989 for synchronous and 0.997 for asynchronous assessments. Intrarater reliability was also high, with ICCs ranging from 0.982 to 0.997 across raters and methods. Regarding concurrent validity, synchronous teleassessment BBS scores showed a strong correlation with face-to-face BBS (<i>r</i> = 0.970) and Timed Balance Test (TBT) scores (<i>r</i> = 0.901), while asynchronous assessments also demonstrated strong correlations (BBS: <i>r</i> = 0.945; TBT: <i>r</i> = 0.885). Correlations with postural sway parameters were moderate, ranging from <i>r</i> =−0.40 to −0.54.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings suggest that synchronous and asynchronous teleassessment of the BBS may be a viable alternative to face-to-face assessments. However, further research with larger samples is needed to support these findings and increase their generalizability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT05263063.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overlapping Systematic Reviews on the Same Topic: A Systematic Literature Review of Quantitative Research","authors":"Shunlong Ou,&nbsp;Jing Luo,&nbsp;Qian Jiang","doi":"10.1111/jep.70148","DOIUrl":"https://doi.org/10.1111/jep.70148","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The number of published systematic reviews has exploded in the past three decades, followed by a large number of overlapping systematic reviews on the same topic. We aim to review the frequency and causes of overlap in systematic reviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following PRISMA 2020 guidelines, we searched PubMed and Embase from inception to March 4, 2024, to identify English-language studies quantitatively assessing overlapping systematic reviews on the same topic. Nonempirical studies and duplicates were excluded. Two researchers independently screened and extracted data, with results analyzed descriptively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eleven quantitative studies were included in this study. Findings revealed that 68% of systematic reviews exhibited overlap, with a maximum of 76 overlapping reviews identified on a single topic. Only 36% overlapping systematic reviews referenced previous studies and a mere of 9% reported protocol registrations. The most mentioned causes for overlap were the omission to reference previous systematic reviews (6; 55%), lack of protocol registration (3; 27%), performance-driven incentives among researchers (3; 27%). Key recommendations to mitigate overlap included mandatory protocol registration (7; 64%), explaining the novelty and innovation of research (5; 45%), strengthening the review of overlap (3; 27%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overlapping systematic reviews undermine evidence reliability due to transparency gaps and methodological weaknesses. Mandatory protocol registration, interdisciplinary collaboration, and adherence to tools like AMSTAR 2 are critical to curb redundancy. Journals must enforce rigorous quality checks and support living reviews. Stakeholders urgently need to standardize definitions of overlap, establish update frameworks, and promote ethical research practices. Addressing these challenges will enhance the efficiency and trustworthiness of evidence synthesis in healthcare.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cross-Sectional Study on the Learning Needs and Satisfaction Levels of Orthopedics and Trauma Surgery Patients at Discharge","authors":"Cemile Nida Kayis,&nbsp;Emine Catal","doi":"10.1111/jep.70145","DOIUrl":"https://doi.org/10.1111/jep.70145","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Research on the learning needs of patients after orthopedic and trauma surgery during the discharge process is limited, and this situation constitutes an important research gap in improving nursing practice and increasing patient satisfaction. Because when the patient's learning needs priorities are examined at discharge, it is not clear to what extent these needs have been met.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to determine the priorities in the learning needs of the patients who underwent orthopedic and trauma surgery at discharge, the level of meeting these learning needs, and the satisfaction level of the routine discharge education. Secondly, it was aimed to determine the effects of demographic and clinical characteristics on these.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study is descriptive, correlational and cross-sectional. The sample included 184 patients. The data were collected using the Personal Information Form, the Patient Learning Needs Scale and the Discharge Education Satisfaction Scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this study, 36.9% of the patients' medical diagnoses were prostheses and 63.1% of them were fractures. While the patients found their learning needs at discharge ‘very important’ (190.28 ± 10.83), they rated these needs as ‘neither more or less met’. The patients reported that they cared more about information regarding treatment and complications and improving the quality of life. The patients' satisfaction level with discharge education was also determined as ‘partially satisfied’ (74.09 ± 3.83). The analysis revealed that the significance of patients' discharge learning needs and the extent to which these needs were met were influenced by factors including age, gender, education level, employment status, medical diagnosis, hospitalization history, and surgical history (<i>p</i> &lt; 0.05). However, the level of satisfaction with discharge education remained unaffected by any of these variables (<i>p</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>It was concluded that the priorities of discharge learning needs in patients who underwent orthopedic and trauma surgery were considered very important, but the satisfaction levels of meeting the needs and discharge education were low.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines on Assistive Products Useful in Pharmacy Practice to Optimize and Ensure Medication Use by Individuals With Visual Impairment: An Interdisciplinary Delphi Consensus","authors":"Théodora Merenda,&nbsp;Stéphanie Patris","doi":"10.1111/jep.70149","DOIUrl":"https://doi.org/10.1111/jep.70149","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Visual impairment represents a significant public health challenge that can affect patients ability to accurately identify medications and access essential information about them. A potential solution to address these difficulties is the utilization of assistive products. Consequently, guidelines have been developed in French for Belgian community pharmacists to enhance the safety of individuals with a visual impairment when utilizing medications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>To build an interdisciplinary consensus on guidelines for the utilization of assistive products in pharmacy practice, with the aim of ensuring the safe administration of medications by individuals with a visual impairment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A Delphi survey for consensus building was conducted by a national panel of experts. The interdisciplinary panel was constituted of ophthalmologists with a specialization in low vision, orthoptists, ergotherapists, psychologists, and community pharmacists. The recommendations were encoded in the form of an online questionnaire and the experts were invited to indicate their degree of agreement on a 9-point Likert scale. Descriptive statistics were produced using IBM SPSS 27 software. This process was repeated until a consensus was reached between all the experts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four rounds of the Delphi method were necessary to the panel of 10 experts to evaluate the 47 recommendations initially submitted. Ultimately, an introduction to the guidelines and 39 recommendations, grouped into six main categories, were validated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The consensus process has enabled us to obtain consolidated recommendations and to ensure their relevance, thus facilitating the dissemination of high-quality content to community pharmacists practising their profession in Belgian pharmacies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Manchester Triage System in the Paediatric Emergency Department—Accuracy of the Nonspecific Presentational Flow Charts","authors":"Tobias G. Strapatsas,&nbsp;Monika Kogej,&nbsp;Uwe Baum,&nbsp;Sabine Keiser,&nbsp;Anna-Lena Lubojanski,&nbsp;Ingo Gräff","doi":"10.1111/jep.70161","DOIUrl":"https://doi.org/10.1111/jep.70161","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In emergency medicine, validated triage systems, such as the Manchester Triage System (MTS), have been established to ensure proper prioritization of patients. In adult patients, using nonspecific flow charts has been shown to be less accurate. In this study, the accuracy of nonspecific paediatric flow charts compared to the more specific flow charts is systematically examined for the first time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective cohort analysis of 28,128 paediatric emergency patients being triaged between November 2021 and April 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the observation period, the nonspecific presentational flow charts ‘unwell newborn/baby/child’, ‘crying baby’ and ‘irritable child’ were used 2695 times. The equally nonspecific flow chart ‘worried parent’ was used 5133 times. Patients triaged with nonspecific paediatric flow charts were often classified in lower triage levels. The AUC for the nonspecific flow charts and hospitalization in general was 0.604 [0.584–0.624] and the nonspecific chart ‘worried parent’ showed a lower AUC 0.594 [0.578–0.61]. The AUC of patients triaged with the more specific flow charts was 0.661 [0.654–0.669]. The AUC for the MTS nonspecific paediatric flow charts and admission to the ICU was 0.865 [0.752–0.978] and 0.782 [0.55–1] for patients triaged with worried parent as well as 0.771 [0.728–0.814] for patients triaged with more specific flow charts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This study is the first to examine the nonspecific paediatric flow charts. Compared to the specific flow charts, the performance of the nonspecific ones shows a significantly worse AUC for admission to the normal ward as a surrogate parameter for accuracy. Since nonspecific paediatric flow charts have many indicator questions at the indicator level that are aimed at nonspecific symptoms compared to the adult range, the poorer performance can be explained by a lack of compliance on the part of the nurse making the initial assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Medical Prescription Skills in Medical Students: A Hands-On Educational Intervention","authors":"Victória Borges Bessa,&nbsp;Alice Ornellas Ferrari,&nbsp;Laura Moreira Sanches,&nbsp;Marcela Viscovini Gomes da Silva,&nbsp;Ricardo Filipe Alves da Costa,&nbsp;Wilson Elias de Oliveira Júnior","doi":"10.1111/jep.70135","DOIUrl":"https://doi.org/10.1111/jep.70135","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Medical prescription forms a crucial link between healthcare providers and patient treatment outcomes. However, inadequate prescription practices pose significant risks, including therapeutic inefficacy and severe health hazards.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>Evaluate the impact of a practical educational course designed to enhance prescription skills among medical students at various stages of their education.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The workshop addressed prescription issues in hospital and ambulatory settings by adopting a descriptive, prospective approach. Data were collected pre- and post-intervention using structured questionnaires and analyzed using non-parametric tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Analysis indicated substantial improvement in students' prescription skills, with statistically significant knowledge gains noted in both early- and advanced-stage students (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite limitations such as sample size and group variability, the study underscores the necessity of integrating innovative, hands-on educational methods into medical curricula to address the often-overlooked skill of medical prescription in the graduation curricula.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cross-Sectional Study on the Knowledge, Attitudes, and Practices of Medical Students Towards the Use of Plaster of Paris","authors":"Vidmi Taolam Martin,&nbsp;Bin Yu","doi":"10.1111/jep.70095","DOIUrl":"https://doi.org/10.1111/jep.70095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Plaster of Paris (POP) serves as a fundamental orthopedic material for fracture immobilization and facilitating the healing process. For medical students, mastering anatomical principles and evidence-based practices is paramount, as these competencies significantly enhance patient outcomes. Proper application of POP not only ensures patient comfort but also minimizes the need for repeated casting or surgical interventions to maintain limb immobilization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>This study compares the knowledge, attitudes, and practices (KAPs) of three groups of medical students regarding the use of POP to evaluate how structured internship impacts their clinical decision-making and patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A structured questionnaire was administered to senior students of the bachelor's degree (4Y-MS and 5Y-MS) and early master's degree students (1Y-MMed) for comparative analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were notable differences among the three groups (4Y-MS, 5Y-MS and 1Y-MMed) in terms of gender, age, preferred specialty during clinical rotation, and specialty of choice (<i>p</i> = 0.004, <i>p</i> &lt; 0.0001, <i>p</i> = 0.009, and <i>p</i> = 0.504, respectively). The 5Y-MS and 1Y-MMed groups reported higher scores for self-practice in applying a POP cast than did the 4Y-MS group [91 (82.73%), 172 (91.71%), and 76 (80.39%)], as collected through a questionnaire. Furthermore, only a small percentage of participants (n = 61) were postgraduate majors in orthopedic surgery, and even fewer (n = 10) received training from attending orthopedic surgeons. The participants' overall knowledge level was relatively low, with a score of 5.76 ± 1.25. Bloom's cut-off point indicates a moderate overall knowledge score of 71.97%, a positive attitude score of 90.75%, and a good practice score of 94.29%. The linear regression analysis revealed that all participants' knowledge levels were significant, but only the 1Y-MMed group's scores increased with the medical curriculum. The medical curriculum and clinical trainer's academic position influenced knowledge scores and attitudes, with the latter being the only factor that led to increased practice items.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The 5Y-MS or 1Y-MMed have better KAP when using a POP cast than 4Y-MS. Trainers’ implication is a key factor in enhancing appropriate attitudes and practices among students.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Audit and Feedback Supporting New Guideline Implementation in Chronic Kidney Disease","authors":"Megan E. Lanpher,&nbsp;Brooke Patterson,&nbsp;Muhammad Ebrahim,&nbsp;Abbas S. Tavakoli","doi":"10.1111/jep.70132","DOIUrl":"https://doi.org/10.1111/jep.70132","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Adults with Type 2 diabetes mellitus and chronic kidney disease experience higher risk for progression to end stage kidney disease, which negatively impacts health, increases medical costs, and decreases quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Determine if an audit and feedback intervention in a local nephrology clinic can increase provider adherence to a clinical practice guideline that supports the prescription of sodium glucose cotransporter-2 inhibitors to delay progression of chronic kidney disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A pretest-posttest design was used to determine if an audit and feedback tool delivered to providers at 3-week intervals would increase provider adherence to the guideline recommendation over the course of 3 months. A clinical decision guide was provided to participants at the onset of the intervention with structured interviews accompanying the audit and feedback cycles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>English speaking physicians and advanced practice providers were recruited from a local nephrology outpatient clinic in the southeastern United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>To evaluate the significance of the intervention, a chi-square test was used to evaluate the change in prescribing of SGLT-2 inhibitors compared to the 3 months before the intervention. Logistic regression assisted with examining the relationship between the intervention and proportion of new SGLT-2 inhibitor prescriptions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this setting, statistical analysis indicated that the intervention significantly increased prescription of SGLT-2 inhibitors in adults with Type 2 diabetes and chronic kidney disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The intervention significantly increased provider adherence to the clinical guideline. Additional implementation on a larger scale is warranted to validate findings and further investigate barriers to prescribing that were reported by participating providers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"East Midlands Breast Pain Pathway: An Evaluation of Community Breast Pain Clinics Across the East Midlands Cancer Alliance","authors":"John F. R. Robertson,&nbsp;Thilan Bartholomeuz,&nbsp;Veronica Rogers,&nbsp;Kevin Clifton,&nbsp;Lucy Pirkle,&nbsp;Denise Stafford,&nbsp;Mike Ryan,&nbsp;D. Mark Sibbering","doi":"10.1111/jep.70150","DOIUrl":"https://doi.org/10.1111/jep.70150","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Research indicates that breast pain as the sole symptom has no association with breast cancer. However, patients with breast pain only are often referred onto urgent breast cancer diagnostic pathways, leading to unnecessary anxiety and overutilisation of secondary health care services. The novel community breast pain clinic (CBPC) service in the UK aims to improve patient care while providing system-wide improvements for patients with breast pain, patients who have ‘red flag’ symptoms, as well as being cost-effective.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim and Objectives</h3>\u0000 \u0000 <p>This study seeks to evaluate and assess the impact of the CBPC on patient care, experience, and healthcare system improvements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Quantitative and qualitative analysis of CBPC was undertaken using data from CBPC based on a core data set designed by the programme team, secondary care follow-up data, Patient Reported Outcomes Measure (PROMs) data and family history data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The CBPC was well-received by patients with 98.5% recommending the service. Additionally, health economic analysis indicated a cost benefit ratio of 1.23 in year 1, indicating a positive return on investment. Breast cancer incidence within the cohort was estimated at 3.2 per 1000, in line with population estimates in the literature. For those with a breast cancer diagnosis, there is no evidence of care delays or missed diagnoses via the service.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The CBPC offers significant benefits in patient experience and value for money, with no evidence of reducing patient safety. The impacts of the clinics appear to be reproducible across all five centres in the East Midlands (a population of 5.5 million). Recommendations on further assessment on optimal staff mix and clinic cost mechanisms should be considered to maximise benefits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Transtheoretical Model-Based Motivational Interviewing on Self-Efficacy and Adherence to Treatment in Hemodialysis Patients","authors":"Hüseyin Çapuk,&nbsp;Rukuye Aylaz","doi":"10.1111/jep.70152","DOIUrl":"https://doi.org/10.1111/jep.70152","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aim(s)&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The aim of this study was to evaluate the impact of Transtheoretical Model-based Motivational Interviewing on self-efficacy and illness adjustment in hemodialysis patients.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Hemodialysis patients often face challenges in adhering to dietary, fluid, and medication guidelines due to the lengthy nature of the dialysis sessions and various associated restrictions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study was conducted between June 2022 and March 2023 at hemodialysis centers in eastern Turkey. It included 30 patients in the experimental group and 30 in the control group. The experimental group received six sessions of Transtheoretical Model-based motivational interviewing, while the control group received no intervention. This pretest-posttest randomized controlled trial was registered in the Clinical Trials Registry (NCT06706843).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The results indicated a significant improvement in GSES scores. A significant difference was found between the groups in pre-test scores (&lt;i&gt;p&lt;/i&gt; &lt; 0.05), and a statistically significant difference was also observed in Posttest scores (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Within-group comparisons revealed significant differences between pretest and posttest scores for the experimental group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). There was a significant difference between pre-test and Posttest scores in the control group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). In the SDBM-NOS showed a significant difference between the experimental and control groups in the dietary adherence subscale at Posttest (&lt;i&gt;p&lt;/i&gt; &lt; 0.05), but no significant difference was found in the other subscales. In the experimental group, a significant improvement was observed between pre-test and Posttest in terms of total ESRD-AS score, fluid compliance and dietary compliance (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). In the control group, no significant difference was found for any variable (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). A significant negative correlation was found between GSES and ESRD-AS.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In conclusion, Transtheoretical Model-based Motivational Interviewing was found to significantly improve treatment adherence and self-efficacy in chronic hemodialysis patients, contributing to better illness adjustment.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;&lt;b&gt;Trial Registration:&lt;/b&gt; ClinicalTrials.gov identifier: NCT06706843.&lt;/p&gt;\u0000 &lt;/sectio","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70152","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}